Lacey Poe, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

A03280 Issued in AR

Practice address

3644 W St Hwy 18
Suite B
Manila, AR 72442

Phone

(870) 561-3300

Fax

(870) 561-3307

NPI assigned

Sep 2, 2009

Last updated

Feb 18, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Riverside Medical Clinic

  • Family Medicine Physician
  • Lake City, AR
  • NPI 1811206923
  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1251849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1205069630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 910",
            "city": "MANILA",
            "state": "AR",
            "postal_code": "724420910",
            "telephone_number": "870-561-3300",
            "fax_number": "870-561-3307"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3644 W ST HWY 18",
            "address_2": "SUITE B",
            "city": "MANILA",
            "state": "AR",
            "postal_code": "72442",
            "telephone_number": "870-561-3300",
            "fax_number": "870-561-3307"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POE",
        "first_name": "LACEY",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-09-02",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AR",
            "license": "A03280",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "179499758",
            "state": "AR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Milestones Speech Therapy, LLC
• Karley Brooke Moore
• Morgan Bliss Noble, APRN
• Jessica Parrish
• Presley Raye Pierce
• Rays Pediatric Therapy PLLC
• Sasha Reyna Richardson, LMSW
• Tonya Rogers, LPC
• Jordin Rone, LAC
• Susan Dianne Sanchez, LAC

• Family Nurse Practitioner in Manila, AR
• Providers in Manila, AR by specialty
• Family Nurse Practitioner in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.